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Gabapentin Dosage

This dosage information may not include all the information needed to use Gabapentin safely and effectively. See additional information for Gabapentin.

The information at Drugs.com is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist.

Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Epilepsy

Initial dose: 300 mg orally on day one, 300 mg orally twice a day on day two, then 300 mg orally 3 times a day on day three.
Maintenance dose: 900 to 1800 mg orally in 3 divided doses. If necessary, the dose may be increased using 300 mg or 400 mg capsules three times a day up to 1800 mg/day. Dosages up to 2400 mg/day have been well tolerated in long-term clinical studies. Doses of 3600 mg/day have also been administered to a small number of patients for a relatively short duration, and have been well tolerated. The maximum time between doses in the three times a day schedule should not exceed 12 hours.

The safety and effectiveness of gabapentin available under the trade name Gralise (R) or Horizant (R) in patients with epilepsy has not been studied.

Usual Adult Dose for Postherpetic Neuralgia

Initial dose: 300 mg orally on day one, 300 mg orally twice a day on day two, then 300 mg orally 3 times a day on day three.

The dose may be titrated up as needed for pain relief to a daily dose of 1800 mg.
Maintenance dose: 900 to 1800 mg orally in 3 divided doses.

Efficacy was demonstrated in clinical studies over a range of 1800 mg/day to 3600 mg/day. However, no additional benefit was demonstrated from the use of doses over 1800 mg/day.

Gabapentin available under the trade name Gralise (R):

Maintenance dose: Gralise (R) should be titrated to 1800 mg orally once daily with the evening meal.

Recommended titration schedule:
Day 1: 300 mg orally with the evening meal
Day 2: 600 mg orally with the evening meal
Days 3 through 6: 900 mg orally with the evening meal
Days 7 through 10: 1200 mg orally with the evening meal
Days 11 through 14: 1500 mg orally with the evening meal
Day 15: 1800 mg orally with the evening meal

Gralise (R) is not interchangeable with other gabapentin products because of differing pharmacokinetic profiles that affect the frequency of administration.

Gabapentin enacarbil extended release tablets available under the trade name Horizant (R):

The recommended dosage is 600 mg orally twice daily. Therapy should be initiated at a dose of 600 mg orally in the morning for 3 days of therapy, then increased to 600 mg twice daily (1,200 mg/day) on day four.

Gabapentin enacarbil extended release tablets available under the trade name Horizant (R) and gabapentin are not interchangeable.

Usual Adult Dose for Restless Legs Syndrome

Gabapentin enacarbil available under the trade name Horizant (R):
600 mg orally once daily with food at about 5 PM

Usual Pediatric Dose for Epilepsy

Less than 3 years: Effectiveness has not been established.

Greater than or equal to 3 and less than 12 years:
Starting Dose: ranges from 10 to 15 mg/kg/day in 3 divided doses.
Effective Dose: reached by upward titration over a period of approximately 3 days. The effective dose of gabapentin in patients 5 years of age and older is 25 to 35 mg/kg/day and given in divided doses (three times a day). The effective dose in pediatric patients ages 3 and 4 years is 40 mg/kg/day and given in divided doses (three times a day). Gabapentin may be administered as the oral solution, capsule, or tablet, or using combinations of these formulations. Dosages up to 50 mg/kg/day have been well tolerated in a long term clinical study. The maximum time interval between doses should not exceed 12 hours.

Greater than 2 years:
Initial dose: 300 mg orally on day one, 300 mg orally twice a day on day two, then 300 mg orally 3 times a day on day three.
Maintenance dose: 900 to 1800 mg orally in 3 divided doses. If necessary, the dose may be increased using 300 mg or 400 mg capsules three times a day up to 1800 mg/day. Dosages up to 2400 mg/day have been well tolerated in long term clinical studies. Doses of 3600 mg/day have also been administered to a small number of patients for a relatively short duration, and have been well tolerated. The maximum time between doses in the three times a day schedule should not exceed 12 hours.

Renal Dose Adjustments

For patients greater than or equal to 12 years:
CrCl less than 15 mL/min: 300 mg orally every other day
CrCl 15 to 30 mL/min: 300 mg orally once a day
CrCl 30 to 60 mL/min: 300 mg orally twice a day
CrCl greater than 60 mL/min: 400 mg orally 3 times a day

The dose of gabapentin available under the trade name Gralise (R) should be adjusted in patients with reduced renal function. Patients with reduced renal function should initiate Gralise (R) at a daily dose of 300 mg. Daily dosing in patients with reduced renal function should be individualized based on tolerability and desired clinical benefit. Gralise (R) should be titrated following the schedule outlined below:
CrCl less than 30 mL/min: Gralise (R) should not be administered
CrCl 30 to 60 mL/min: 600 to 1800 mg orally with the evening meal
CrCl greater than or equal to 60 mL/min: 1800 mg orally with the evening meal

The dose of gabapentin enacarbil available under the trade name Horizant (R) should be adjusted in patients with reduced renal function as follows:

Restless Legs Syndrome:
CrCl greater than or equal to 60 ml/min: 600 mg orally once a day
CrCl 30 to 59 ml/min: Start at 300 mg orally daily and increase to 600 mg as needed
CrCl 15 to 29 ml/min: 300 mg orally once a day
CrCl less than 15 ml/min: 300 mg orally every other day
CrCl less than 15 ml/min on dialysis: not recommended

Postherpetic Neuralgia:
CrCl greater than or equal to 60 ml/min: 600 mg orally in the morning for 3 days, then 600 mg twice a day thereafter.
CrCl 30 to 59 ml/min: 300 mg orally in the morning for 3 days, then 300 mg twice a day thereafter. Increase to 600 mg twice daily as needed based on tolerability and efficacy.
CrCl 15 to 29 ml/min: 300 mg orally in the morning on day 1 and day 3 of therapy, then 300 mg once a day in the morning. May increase to 300 mg twice daily if needed based on tolerability and efficacy.
CrCl less than 15 ml/min: 300 mg orally every other day in the morning. May increase to 300 mg once daily in the morning if needed based on tolerability and efficacy.
CrCl less than 15 ml/min on dialysis: 300 mg orally following every dialysis. May increase to 600 mg following every dialysis if needed based on efficacy and tolerability.

Liver Dose Adjustments

Data not available

Dose Adjustments

If the dose of gabapentin available under the trade name Gralise (R) is reduced, discontinued, or substituted with an alternative medication, this should be done gradually over a minimum of one week or longer or as directed by the physician.

If the dose of gabapentin enacarbil available under the trade name Horizant (R) is discontinued, patients with RLS receiving 600 mg or less once daily can discontinue the drug without tapering. Patients with PHN receiving Horizant (R) twice daily should reduce the dose to once daily for 1 week prior to discontinuation to minimize the potential for withdrawal seizure.

Precautions

If gabapentin is discontinued and/or an alternate anticonvulsant medication is added to the therapy, this should be done gradually over a minimum of 1 week.

The safety and effectiveness of gabapentin available under the trade names Gralise (R) or Horizant (R) in patients with epilepsy has not been studied.

Gabapentin available under the trade names Gralise (R) or Horizant (R) are not interchangeable with each other or with other gabapentin products.

Gabapentin available under the trade name Gralise (R) should be titrated to the maintenance dose.

Gabapentin available under the trade names Gralise (R) or Horizant (R) tablets should be swallowed whole, not crushed, split, or chewed.

If the dose of gabapentin available under the trade name Gralise (R) is reduced, discontinued, or substituted with an alternative medication, this should be done gradually over a minimum of one week or longer or as directed by the physician.

An antacid containing aluminum hydroxide and magnesium hydroxide reduced the bioavailability of gabapentin immediate release by about approximately 20%, but by only 5% when gabapentin was taken 2 hours after antacids. It is recommended that gabapentin available under the trade name Gralise (R) be taken at least 2 hours following antacid administration.

Safety and effectiveness of gabapentin available under the trade names Gralise (R) or Horizant (R) have not been established in pediatric patients (less than 18 years of age).

Dialysis

A 200 to 300 mg dose should be administered following dialysis.

Gabapentin available under the trade name Gralise (R) is contraindicated in patients receiving dialysis.

Gabapentin enacarbil available under the trade name Horizant (R):
RLS:
CrCl less than 15 ml/min on dialysis: Not recommended
PHN:
CrCl less than 15 ml/min on dialysis: 300 mg orally following every dialysis. May increase to 600 mg following every dialysis if needed based on tolerability and efficacy.

Other Comments

Gabapentin may be given with or without food. Gabapentin enacarbil available under the trade name Horizant (R) should be taken with food.

Gabapentin available under the trade name Gralise (R) should be taken once daily with the evening meal.

Gabapentin enacarbil available under the trade name Horizant (R) should be swallowed whole and should not be cut, crushed, or chewed. For RLS, a daily dose of 1,200 mg provided no additional benefit compared with the 600 mg dose, but caused an increase in adverse reactions. For PHN, a daily dose greater than 1,200 mg conferred no additional benefit and resulted in an increase in adverse reactions.

If the dose of Horizant (R) is not taken at the recommended time, it should be skipped, and the next dose should be taken at the time of the next scheduled dose.

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